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Fig. 5 | Journal of Foot and Ankle Research

Fig. 5

From: Foot loading is different in people with and without pincer nails: a case control study

Fig. 5

Hypothesis for the development of pincer and ingrown nails. Under normal conditions, the upward mechanical force and the constitutive nail shrinkage force are generally well-balanced and the nail remains normally curved. However, in some people, the constitutive nail shrinkage force may exceed the upward mechanical force, either because the patient lacks sufficient mechanical forces on the nail due to being bedridden or wearing ill-fitting shoes or because the constitutive nail shrinkage force is excessive due to genetic or systemic disease influences. In these cases, the nails curve inward. Inappropriate nail cutting promotes nail overcurvature by inducing inflammation and pain, which causes the patient to seek to reduce pressure on the nail further by reducing ambulation, changing the gait, or wearing ill-fitting shoes. In walkers, this vicious cycle may be abrogated by correcting the gait and shoes

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